Coping with worry

KATIE HAMPSON

November 05, 2014

Imagine a GP says your partner has the flu. That night there is a news segment on TV about adult leukaemia and you notice some of your partner’s symptoms overlap - fever, night sweats and painful bones.

Being such broad symptoms, most people would not think to draw a comparison or, at the very least, could rationalise any concerns away.

But you can’t help wondering; could the GP have been wrong about the flu?

You urgently book another appointment and the doctor confirms there is no reason to suspect anything other than the flu but you are still not reassured and trawl the internet for more information late into the night.

You are too tired to attend work the next day and, in the pit of your stomach, anxiety is building about the future.

What if you need to ask your employer for time off work to care for your partner? Will you lose your job? Without a job, what if you can’t afford the medical treatment designed to help him?

You then start to picture life without your partner and wonder if you will be able to cope.

This is how a person who has Generalised Anxiety Disorder (GAD) might think. It might sound far-fetched but such thought processes are very real, frightening and exhausting for the people who endure them.

Such gnawing worry - about serious matters and things most people perceive as inconsequential - is a persistent way of life for people experiencing GAD and it can have disabling consequences.

Put simply, it can feel a bit like the panic button is permanently stuck.

“GAD has an insidious and slow progression and it starts off as an extension of what the person’s character type is really like,’ explains psychiatrist Sean Hood, who specialises in clinical anxiety disorders.

“But one of the things a person with GAD will do is spend a lot of time worrying about rather mundane things and go through cascading ‘what if’ scenarios.

“We all get some of those thoughts from time to time, of course, but we can brush it off and move on to doing whatever our normal activities are.

“People who suffer anxiety disorders find it increasingly difficult to brush those worries off and end up spending excessive time on them and increasingly it gets in the way until ultimately they are not able to function.”

According to beyondblue, the non-profit organisation raising awareness about anxiety and depression, about 14 per cent of Australians, or 1 in 7, experiences an anxiety disorder and nearly 6 per cent will experience GAD in their lifetime. It affects more women than men and can strike all age groups, including children and older people.

The Diagnostic and Statistical Manual of Mental Disorders, which is used by clinicians internationally to help diagnose mental illnesses, defines GAD as excessive worry about at least two life circumstances, sustained over a period of six months or longer.

Adult patients must also be suffering from at least three of the six symptoms of anxiety - restlessness, fatigue, impaired concentration, muscle tension, sleep disturbance and irritability - to receive a clinical diagnosis and treatment.

It helps distinguish anxiety as a disorder against other possibilities, such as a personality trait. Many have reported experiencing a nameless dread and feeling threats that are located in the future, such as worrying about ruination or humiliation.

Professor Hood, who is also head of the school of psychiatry and clinical neurosciences at the University of Western Australia, points out that, by contrast, normal levels of apprehension - or anxiety when it’s not excessive - are necessary and instinctive human functions which serve as a protective mechanism.

“A typical example is someone who has an exam coming up and they worry but it’s not impairing and they use that anxiety to motivate them so they perform well,” he said.

While it is not entirely understood by researchers yet why some people cope with, and even thrive on, worry and others are made ill by it, anxiety disorders are on the rise in Australia.

Professor Hood said many people did not realise anxiety was treatable so they lived in quiet pain and those who eventually sought treatment tended to do so when the anxieties had escalated to crisis point.

“One of the joys of working with anxiety disorders is that the majority of patients I see, once they are treated, get back to work and their life roles and that is very rewarding,” he said.

One type of therapy, Cognitive Behavioural Therapy (CBT), effectively serves to challenge the worrying voices in the head.

Professor Hood said a certain form of CBT involving mindfulness-based therapies was shown to be helpful for people with GAD.

“With therapy, we would gradually try to get them outside of their comfort zone to reduce the negative impact of the disorder,” he said.

“Ultimately, it’s not about erasing all the anxieties they have, because anxiety is a normal part of being human, it’s just about balancing it so it’s manageable.”

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